Facing Retirement

Caption: Sherman James leads a Sanford School class. James is retiring this June. Photo by Les Todd/Duke University Photography

The career of Sherman James, Susan B. King Professor of Public Policy, who will retire in June, exemplifies the interdisciplinary scholarship that the Sanford School prizes and nurtures.

A psychologist who has worked in departments of medicine and epidemiology, who founded a research center on health and culture, and whose work on health disparities led to his creation of the "John Henryism Hypothesis," James has worked in many disciplines.

In 1973, after earning his doctorate in psychology from Washington University in St. Louis, James joined the epidemiology department in the UNC-Chapel Hill School of Public Health.

"Cardiovascular disease has a strong behavioral and psychological component, and I saw the chance to conduct interesting and potentially useful research. The department offered a perspective that was very intriguing to me," James said.

James became interested in racial differences in cardiovascular disease. The department had a rich research program on this topic, and had begun collecting data in the early 1960s. African-American men were known to have the greatest risk for hypertension, which is a major risk factor for heart disease. In the early 1980s, James initiated a study in eastern North Carolina, a region known for very high rates of hypertension and heart disease, in search of new insights into ways to help African Americans in the region control or prevent high blood pressure.

In preparation for this work, he collected oral histories of black men with hypertension, one of whom had risen out of deep childhood poverty and came to own a 100-acre farm after years of struggle against economic hardship and racial discrimination. He told James he thought his lifelong struggle to be successful had contributed to his health problems. The man's name was John Henry Martin.

A statue of John Henry, "the steel-driving man."

His story was very reminiscent, James said, of the legend of John Henry, the steel-driving man, who beat a mechanical steam drill in an epic contest of "man against machine," but dropped dead afterwards from complete exhaustion. This legend has always had great resonance in the black community, James added. With its theme of being persistent even in the face of great odds, the legend offered "a way for black Americans, especially working-class blacks, to make sense of their lives as an historically oppressed group. Its core message regarding working hard and staying optimistic became essential in the socialization of black American children," James said.

James decided to investigate, scientifically, what he came to call the "John Henryism Hypothesis; "the idea that poor and working class individuals, especially African Americans, who engage in "high-effort coping" with difficult social and economic circumstances over many years may be at increased risk to develop hypertension and heart disease much earlier in life than people who have more social and economic resources to pursue their dreams. He developed a 12-item scale to measure, persistence, commitment to hard work, optimism and other "John Henry" characteristics.

In a series of studies in eastern N.C. during the 1980s, he found that African Americans who scored high on the John Henryism Scale and were also economically disadvantaged had the highest blood pressure levels. Interestingly, those who scored high on John Henryism and had relatively high levels of education and income had the lowest blood pressure levels. This suggests, said James, that there is nothing inherently problematic about possessing a healthy dosage of "John Henry" traits. The problem, in terms of accelerated risk for cardiovascular disease, arises when such determined striving occurs in the face of strong racial and economic headwinds.

James expanded on this work at the University of Michigan where he taught from 1989 to 2003. At Michigan, in addition to being a professor of epidemiology in the School of Public Health, he was named the John P. Kirscht Collegiate Professor of Public Health and founded the Center for Research on Ethnicity, Culture, and Health (CRECH). He was also a senior research scientist at the Institute for Social Research, and chaired the department of Health Behavior and Health Education from 1999 to 2003.

"To the best of my knowledge," James said, CRECH was the first academic unit in a U.S. school of public health to focus on how cultural differences, racism, ethnicity, and variations in socioeconomic circumstances interact with each other to influence US health disparities."

James came to Duke in 2003, where he also holds appointments in sociology, community and family medicine and African and African-American studies. "You could hardly ask for a more interdisciplinary group than at Sanford. The opportunity to work with, and learn from, economists, historians and political scientists, has been very rewarding, and the students have been great – smart, respectful and idealistic," he said.

The position also offered James the chance to return to the South, closer to where he had grown up in Hartsville, S.C., and to be available to his mother, who is now 93.

James applied the John Henryism hypothesis to other populations, including the Dutch in a 1998 study, and the Finns, in a study nearing publication. The Finns, it turns out, have an ancient and very similar concept to John Henryism called "sisu," which means bravery and determination in face of adversity. It is seen as central to the Finnish character, the word that describes the essence who they are.

His articles on the John Henryism hypothesis have garnered hundreds of citations and dozens of dissertations and journal articles by other scholars. Researchers at Northwestern University and the University of Georgia have found similar health effects in low-income children who are successful in school.

Such an influential career has earned James numerous honors. He was elected to the Institute of Medicine of the National Academy of Sciences in 2000. He is a fellow of the American Epidemiological Society, the American College of Epidemiology, the American Heart Association and the Academy of Behavioral Medicine Research.

"It's been a privilege to have this kind of career; it was not something I had expected, he said.

After leaving Duke, James plans to relocate to Atlanta, where he has family and will do some teaching and research at Emory University and the Centers for Disease Control. He also will continue writing. He is working on a book dealing with how progressive public policies of the 1960s Civil Rights-Era fostered major and fairly rapid improvements in the health of black Southerners. He is also nurturing a new idea, "one that could be as fruitful as the John Henryism hypothesis, but I'm not quite ready to talk about that," he said.